Principal Care Management

CPT states, “Principal care management represents services that focus on the medical and/or psychological needs manifested by a single, complex chronic condition expected to last at least 3 months and includes establishing, implementing, revising, or monitoring a care plan specific to that single disease.”

This FAQ addresses the following:

1. What is principal care management (PCM)?
2. What are the required elements of PCM?
3. What is high risk?
4. Who can provide PCM?
5. When is PCM reasonable and necessary?
6. How is PCM reported on a claim?
7. What is Medicare’s allowable for PCM?
8. Can PCM be combined with other services?
9. How is PCM documented?

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